As temperatures cool heading into the winter season in Central Texas, pollen counts from Ashe juniper trees begin to climb, causing seasonal allergies referred to locally by residents as “cedar fever.”

According to the Texas A&M Forest Service, Central and West Texas is home to about 10 million acres of Ashe Juniper—also known as a mountain cedar—trees. Female Ashe junipers have berries and cones, while male trees cause the airborne pollen, according to the service.

Sumit Bose, an allergist/immunologist with Baylor Scott & White Health, told Community Impact Newspaper on Dec. 6 that cedar fever is fairly unique to Texas due to the large concentration of the trees.

“The interesting thing is that, in most of the United States, and especially in northern United States where you don’t have a lot of cedar trees, people actually get some relief from pollen allergies in the winter,” he said. “But here in Texas people continue to struggle with pollen allergies just because of the unique cedar allergies that we have.”

Cedar season runs from December-February


Bose said cedar trees pollinate for about three months out of the year, from December to February.

“By the end of February cedar trees stop pollinating, so typically people stop having symptoms of cedar allergies by early spring,” he said.

However, other pollen allergens are present in Central Texas throughout the year, including tree pollen in the spring, native grass allergies in the summer, and pollen from weeds in the fall.

“It is not uncommon for patients to be allergic to multiple things,” he said. “We routinely see patients suffer from tree pollen allergies in March and April [after cedar is no longer present].”


Cedar fever symptoms mimic the common cold

Bose said the name “cedar fever” is bit of a misnomer because typically people do not suffer from an actual fever but experience similar symptoms to a fever or cold. According to Bose, typical symptoms of cedar allergies include nasal congestion; sneezing; itchy, watery or puffy eyes; sore throat; coughing; and fatigue.

Winter is, however, still peak season for the common cold, the flu and other illnesses, and also brings with it an increase in dust allergies. Bose said those experiencing symptoms that are inconsistent with cedar pollen counts or inconsistent year to year could be catching colds or suffering from allergies that are not cedar-related.

Preventive measures before cedar season can help


Bose said many patients come in already suffering from severe allergies, when it could be too late for preventive measures to work. Taking an allergy-relief intranasal steroid spray prior to the season and “not playing catch up” when pollen counts rise can help reduce or fight off symptoms.

“If people have a documented cedar allergy, they should start using their nasal sprays at least a week or two before cedar season,” he said, “Think of Thanksgiving as a reminder that you should start using your nasal spray regularly, and stay on it continuously through the season to be the most effective.”

Other techniques can help reduce symptoms

Bose said he recommends that once cedar season begins, those prone to the allergen keep track of pollen counts and stay indoors when counts are high. If required to spend extended time outside, he said to change clothes once back inside and to shower before bed to remove any pollen, preventing exposure at night.


Nasal saline washes can help clean pollen out from nasal and sinus cavities, he said. Over-the-counter medications—such as antihistamines and intranasal steroid sprays—can be taken on an as-needed or daily basis, he said.

Bose said that seeing a board-certified allergist could also offer additional solutions or help pinpoint if cedar or other allergens are causing symptoms. Allergists can conduct allergy tests that can review what a patient is allergic to. Allergists can also administer immunotherapy, which can help the body build up a tolerance to an allergen over time, according to Bose.

People new to the region may not experience allergies right away

Bose said in order for an individual to develop an allergy, he or she has to have enough exposure to the pollen for a few years. Because of this, those new to Central Texas may not feel symptoms the first few years they live in the region but could develop the allergy later on.


“Sometimes we tend to hear that people who have moved down to Central Texas area initially don't have any symptoms of cedar fever, and that's actually true,” he said.